Provider Demographics
NPI:1396342366
Name:HALLFORD-REESE, CHELSEA (RN, AG-ACNP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HALLFORD-REESE
Suffix:
Gender:F
Credentials:RN, AG-ACNP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:HALLFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 ETHAN WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2296
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 ETHAN WAY STE 600
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2296
Practice Address - Country:US
Practice Address - Phone:916-482-7623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015598363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner